End of Life Care Pathway Audit Tool for Residential Services for Older Persons

Residential Unit Name: ______

Objective of Audit tool:

This audit tool is to be used to retrospectively audit the End of Life Care Pathwaysimplemented in a Residential Care Unit in HSE.

Methodology:

Inclusion Criteria: All residents for whichEnd of Life Care Pathways were implemented in ______(insert location)

Frequency of Audit: e.g. Six chartstwice yearly or following incident/complaint in relation to End of Life Care

(*Note: this is just a suggestion – frequency to be determined by each individual service)

Method:This is a retrospective care plan audit

Feedback:Completed Audit Tool to be kept in the Audit File on the Unit.

Final page of the Audit Tool to be forward to the Director of Nursing for information and onward reporting.

Ward / Date of Audit
Auditor(s) Name(s) / Auditor(s) Title (s)
Resident Identifier (name/ medical card number) / 1. / 2. / 3.
4. / 5. / 6.

Methodology: RecordY for Yes, if the item is found in the resident’s care record.

Record N for No, the item is not present or N/Afor Not applicable

End of Life Care Pathway Audit Tool Residential Care Service

Residential Unit Name: ______

Section A: When a resident enters the end of life care pathway

Criteria / 1 / 2 / 3 / 4 / 5 / 6
A1 / The patients physical needs were met on the end of life care pathway
A2 / The patients emotional needs were met on the end of life care pathway
A3 / The patients spiritual needs were met on the end of life care pathway
A4 / The residents GP was informed of the deterioration and a medical review took place
A5 / The residents wishes regarding end of life care were discussed and documented
A6 / Where a patient is incapacitated his/her representative was consulted and this is documented
A7 / Palliative care needs are assessed and documented where appropriate
A8 / A referral was made to the palliative care team if required
A9 / A multidisciplinary approach to end of life care was implemented in conjunction with the palliative care team.
A10 / The patient was not transferred to the acute setting except for explicit medical reasons which were documented
A11 / The residents family have access to appropriate overnight facilities where required
A12 / Staff have received appropriate training and guidance in end of life care
Total Scores for Yes
Total Scores for No
Total Scores for N/A
% Total =Total Scores for Yes X 100
12 - N/A

Comment:______

Section B: Processes implemented following death of Resident (RecordY for Yes, N for No or N/Afor Not applicable)

Criteria / 1 / 2 / 3 / 4 / 5 / 6
B1 / The residents’ family were given practical information following the death i.e. how to register the death etc. This is documented.
B2 / Procedures are in place for the return of the residents personal effects and this is documented.
B3 / The residents body is treated in accordance with the family’s wishes and cultural beliefs and this is documented
B4 / The coroners office is notified of the death of the resident and this is documented
B5 / Other residents and staff are facilitated in the grieving process and can have a remembrance event.
Total Scores for Yes
Total Scores for No
Total Scores for N/A
% Total =Total Scores for Yes X 100
5 - N/A

Comment:__________

Section C: Audit Outcomes and Recommendations

Unit: ______Ward: ______Date: ______

Audit Results / 1 / 2 / 3 / 4 / 5 / 6
% Total Compliance / % Total Compliance / % Total Compliance / % Total Compliance / % Total Compliance / % Total Compliance
Section A
Section B
Audit Outcomes / 1 / 2 / 3 / 4 / 5 / 6
Yes / No / Yes / No / Yes / No / Yes / No / Yes / No / Yes / No
Correct EOLPathways were appropriately applied at all times
There were deviations from the correct EOLPathways
Recommendations for improvement are required
Recommendations arising from the audit: / Date for completion / Responsibility
Recommendation 1
Recommendation 2
Recommendation 3
Recommendation 4
Recommendation 5
Recommendation 6

Auditor Signature:______Date: ______

CNM Signature:______Date: ______

Director of Nursing Signature: ______Date: ______

Audit Tool for End of Life Care Pathways, QPS DML, June 2014 Page 1 of 4